Influential Factors Affecting Intestinal Anastomotic Leakage and Their Predictive Significance

Background: The occurrence of anastomotic leakage following intestinal surgery stands as a significant contributor to postoperative complications and fatalities. This prospective study was conducted with the aim of assessing different factors associated with the risk of anastomotic leakage. Methods: This study was carried out within the Department of Surgery over the course of one year. It encompassed patients who underwent intestinal anastomosis, whether in emergency situations or as part of routine surgical procedures. The study encompassed a total of 150 patients. Results: Anastomotic leakage was identified in 18.02% of cases, with a higher incidence among males and individuals from a lower socioeconomic background. However, age, gender, and socioeconomic status were not found to be significant risk factors for anastomotic leakage. The incidence of leaks was elevated in patients with chronic illnesses such as malignancy, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and those on chronic corticosteroid therapy. Additionally, malnourished patients and those with sepsis, as indicated by their blood investigation reports, had a notably higher leak rate. After conducting logistic regression analysis, several independent predictors for anastomotic leaks were identified, including peritonitis (\(p< 0.05;\) odds ratio \(2.156\)), bowel obstructions (\(p< 0.05\); odds ratio \(2.864\)), receiving more than 2 units of blood transfusion (\(p< 0.05\); odds ratio \(2.334\)), serum albumin levels \(< 3.0\) gm/dL (\(p< 0.001\); odds ratio \(8.873\)), corticosteroid therapy (\(p< 0.001\); odds ratio \(4.877\)), serum creatinine levels \(>1.2\) mg/dL (\(p< 0.001\); odds ratio 11.785), surgery duration exceeding 4 hours (\(p< 0.01\); odds ratio 3.0251), and ASA Grading (III & IV) (\(p< 0.01\); odds ratio 3.707). Conclusion: This study has successfully identified key risk factors that influence the occurrence of anastomotic leakage. The findings from this research are expected to be valuable in efforts to mitigate the incidence of anastomotic leakage following surgery.